There has been a move in medicine towards patient-centred care, leading to more demands from patients for particular therapies and treatments, and for wish-fulfilling medicine: the use of medical services according to the patient's wishes to enhance their subjective functioning, appearance or health. In contrast to conventional medicine, this use of medical services is not needed from a medical point of view. Boundaries in wish-fulfilling medicine are partly set by a physician's decision to fulfil or decline a patient's wish in (...) practice. In order to develop a better understanding of how wish-fulfilling medicine occurs in practice in The Netherlands, a qualitative study (15 semistructured interviews and 1 focus group) was undertaken. The aim was to investigate the range and kind of arguments used by general practitioners and plastic surgeons in wish-fulfilling medicine. These groups represent the public funded realm of medicine as well as privately paid for services. Moreover, GPs and plastic surgeons can both be approached directly by patients in The Netherlands. The physicians studied raised many arguments that were expected: they used patient autonomy, risks and benefits, normality and justice to limit wish-fulfilling medicine. In addition, arguments new to this debate were uncovered, which were frequently used to justify compliance with a patient's request. Such arguments seem familiar from conventional medicine, including empathy, the patient–doctor relationship and reassurance. Moreover, certain arguments that play a significant role in the literature on wish-fulfilling medicine and enhancement were not mentioned, such as concepts of disease and the enhancement–treatment dichotomy and ‘suspect norms’. (shrink)

Background Massively parallel sequencing techniques, such as whole exome sequencing (WES) and whole genome sequencing (WGS), may reveal unsolicited findings (UFs) unrelated to the diagnostic aim. Such techniques are frequently used for diagnostic purposes in pediatric cases of developmental delay (DD). Yet policy guidelines for informed consent and return of UFs are not well equipped to address specific moral challenges that may arise in these children’s situations. Discussion In previous empirical studies conducted by our research group, we found that it (...) is sometimes uncertain how children with a DD will develop and whether they could come to possess capacities for autonomous decision-making in the future. Parents sometimes felt this brought them into a Catch-22 like situation when confronted with choices about UFs before undergoing WES in trio-analysis (both the parents’ and child’s DNA are sequenced). An important reason for choosing to consent to WES was to gain more insight into how their child might develop. However, to make responsible choices about receiving or declining knowledge of UFs, some idea of their child’s future development of autonomous capacities is needed. This undesirable Catch-22 situation was created by the specific policy configuration in which parents were required to make choices about UFs before being sequencing (trio-analysis). We argue that this finding is relevant for reconfiguring current policies for return of UFs for WES/WGS and propose guidelines that encompass two features. First, the informed consent process ought to be staged. Second, differing guidelines are required for withholding/disclosing a UF in cases of DD appropriate to the level of confidence there is about the child’s future developmental of autonomous capacities. Conclusion When combined with a dynamic consent procedure, these two features of our guidelines could help overcome significant moral challenges that present themselves in the situations of children undergoing genomic sequencing for clarifying a DD. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Full Collection of Personal NarrativesZohar Lederman, Ola Ziara, Rachel Coghlan, Oksana Sulaieva, Anna Shcherbakova, Oleksandr Dudin, Vladyslava Kachkovska, Iryna Dudchenko, Anna Kovchun, Lyudmyla Prystupa, Yuliya Nogovitsyna, Ghaiath Hussein, Kathryn Fausch, P. P. Kyaw, Ayesha Ahmad, Richard W Sams II, Handreen Mohammed Saeed, Artem Riga, Ryan C. Maves, Elizabeth Dotsenko, Irina Deyneka, Eva V. Regel, and Vita Voloshchuk• An Unsettling Affair• How We Keep Caring While Walking Through Our (...) Pain• Adjusting Laboratory Practices to the Challenges of Wartime• Why We Stay• A Semi-Personal Story from a Ukrainian NGO Professional (or a Semi-Professional Story from a Ukrainian Person) Living through the War• When Ethics Survives Where People Do Not: A Story From Darfur• Burma’s Healthcare Under Fire: My Experience as an Exiled Medical Professional• When a Conflict Collapses on a Child: An (Aborted) Medical Evacuation of a Hazara Toddler During the Kabul Airport Blast and the Taliban Takeover• The Vagaries and Vicissitudes of War• Providing Care to a Potential Aggressor: An Ethical Dilemma• One Surgeon’s Experience During Armed Conflict in Ukraine• The Limits of Our Obligations• A Liberating Breath• Soldiers of the Invisible Front: How Ukrainian Therapists Are Fighting for the Mental Health of the Nation Under Fire• Stories of Families with Chronically Ill Pediatric Patients during the War in UkraineCopyright © 2023 Johns Hopkins University Press... (shrink)

This intervention study examined the effects of a career crafting training on physicians' perceptions of their job crafting behaviors, career self-management, and employability. A total of 154 physicians working in two hospitals in a large Dutch city were randomly assigned to a waitlist control group or an intervention group. Physicians in the intervention group received an accredited training on career crafting, including a mix of theory, self-reflection, and exercises. Participants developed four career crafting goals during the training, to work on (...) in the subsequent weeks, after which a coaching conversation took place over the phone. Physicians in the control group received no intervention. A pre- and post-test 8 weeks later measured changes in job crafting and career self-management and employability of 103 physicians that completed the pre- and post-test. RM ANOVAs showed that the intervention enhanced perceptions of career self-management and job crafting behavior to decrease hindering job demands. No support was found for the effect of the intervention on other types of job crafting and employability. This study offers novel insights into how career crafting can be enhanced through training, as this is the first empirical study to examine a career crafting intervention. HR managers can use the outcomes to develop tailored career policies and career development practices. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Mere ReadingEva T. H. BrannI recall reading in college, some half a century ago, that the first Queen Elizabeth once represented herself to her people as “mere English.” She meant that she was English pure and simple, nothing but English. I want to set out a way with books, primarily but not only those ranged under “literature,” that I think of as mere reading. Neither the phrase “mere (...) reading” or “mere close reading” is new with me, nor is the mode, and I do not imagine myself on a lonely quest for some lost hermeneutic Eden. Children and the literate public merely read all the time. So do scholars liberated from the professional impositions of graduate school; they have achieved what Thomas Mann calls “the second ingenuousness.” They have read the articles claiming that all books and all approaches to books are of necessity theoretically or ideologically skewed and that a job of rectification, thorough enough perhaps even to postpone the actual reading indefinitely, is a precondition of liberation from the author’s subtle or unconscious agenda. Yet they have liberated themselves from the liberators, well knowing that if it’s a gift to be simple, it is also an achievement.I am, therefore, far from thinking that facing a book simply—facing it without “confronting” it—is an obsolescent activity or that either the straight and trustful reading of books or the making of books that present themselves to be so read is in real danger. I no more fear an impending cultural Armageddon than I long for a past interpretational paradise. For one thing, this is a golden age for the English novel, the premier genre of the present. All the assimilated immigrants and quondam colonials, with their delight in the elegancies of mere high English and their loving mastery of its local varieties, are writing their way into the center of English novelistic literature. They seem quite [End Page 383] aware of all those “readings”—Marxist, feminist, deconstructionist, etc. Nevertheless they write merrily on for an ingenuous yet discerning public.Consequently, the following baker’s dozen of preconditions and precepts are presented not with a sense of fending off impending doom, but for the pleasure of recognition they might give to those who have come to similar conclusions. In these pages I am apt to be preaching to the choir and, truth to tell, I feel no vocation to convert the unbelievers, the more so since I am convinced that it takes all kinds.1. The First-Person PluralThe coopting “we” is more insidiously imperial than ever was the regal first-person plural. Recall all the sentences in public intellectual speech that tell us what “we” all are thinking or are no longer permitted to think or are now required to think (or do) in matters intellectual in general and in matters interpretational in particular, by reason of our historical situation.When I read one of these dicta pushing and pulling me into my place in time or society, every aversive fiber tenses and signals “who ‘we’?—not me!” For the very thing said in our name to be needful may well be the thing most harmful and the impermissible move the one really required. It seems to me worth considering that in an analysis of “our historical situation” it might be the “our” that is the vitiating flaw.Precept: Don’t say “we” unless you have obtained consent. Try “I” or “some of us.” In particular, always qualify announcements of apocalypse so as to leave room for non-participants. This frame of mind is good for turning from sophisticated to mere reading.2. Critical SuperiorityJudges on their benches sit over the sinners arraigned before them, but that the critics in their studies should be above the writers who are their “subject” is plain comical. For one thing, judging is a social necessity, while criticizing is a discretionary activity; some of us could live without it. Some professors make students believe that criticism is work while writing is a self-indulgence that needs to be curbed. In truth, it is the other way around: the critic is parasitic on the writer; if nothing... (shrink)

In this thesis, I attempt to reconcile two alternative approaches to justice: distributive and relational egalitarianism. When examining the two accounts, I claim that relational egalitarianism has distributive egalitarian implications. This implies an extensional overlap between the two accounts, namely a correspondence between the normative outcomes of relational and distributive egalitarianism. This work is addressed primarily to relational egalitarian scholars, as well as others who are convinced by the value of relational equality as a worthy moral and political ideal. My (...) aim is to prove that their goal implies embracing equality of distribution beyond relational equality. When making the case that relational egalitarians should take equality seriously, I claim that they should refrain from embracing distributive principles other than – or incompatible with – principles of distributive equality. This statement entails both a negative and a positive thesis. On the negative side, we should be critical toward the prominent tendency within the relational egalitarian debate, as influenced by the work of Elizabeth Anderson, to reject claims of distributive egalitarian justice in favour of sufficientarian claims of distribution. On the positive side, distributive equality is required by the logic of relational egalitarianism, although its normative significance exists independently of it. While presenting my statements, I provide support for the externalist understanding of relational equality as most recently advanced by Kasper Lippert-Rasmussen, through which the egalitarian character of someone’s relation depends on features external to their relation, such as on the distribution of the relevant currency among them. Whether or not individuals relate to one another as equals – I maintain – depends not merely on the internal feature of their relation, that is, on how they perceive or regard one another, but also, significantly, on how goods such as resources, welfare or opportunities are distributed among them. On my account, individuals are only equals when they recognize each other as equal in status and grant one another an equal share of the justice-relevant good. In defending my thesis, I critically engage with the literature on both distributive egalitarianism and relational egalitarianism. In particular, in the first part, I reconstruct the egalitarian debate and its approach to equality as either a relational or a distributive ideal. In the second part, I question such either/or relation by arguing that relational equality implies distributive equality, because arbitrary distributive inequality violates the deliberative constraint of relating as equals. I strengthen this claim by looking at the particular instantiation of distributive inequality in the field of education, and unveil its theoretical implications while supporting the project of reconciling distributive egalitarian and relational egalitarian approaches to justice. In my view, relational and distributive egalitarianism are compatible theories within one and the same egalitarian framework. Their normative outcomes are – at least in part – equivalent. (shrink)

Disproportional morbidity and mortality experienced by ethnic minorities in the UK have been highlighted by the COVID-19 pandemic. The ‘Black Lives Matter’ movement has exposed structural racism’s contribution to these health inequities. ‘Cultural Safety’, an antiracist, decolonising and educational innovation originating in New Zealand, has been adopted in Australia. Cultural Safety aims to dismantle barriers faced by colonised Indigenous peoples in mainstream healthcare by addressing systemic racism.This paper explores what it means to be ‘culturally safe’. The ways in which New (...) Zealand and Australia are incorporating Cultural Safety into educating healthcare professionals and in day-to-day practice in medicine are highlighted. We consider the ‘nuts and bolts’ of translating Cultural Safety into the UK to reduce racism within healthcare. Listening to the voices of black, Asian and minority ethnic National Health Service (NHS) consumers, education in reflexivity, both personal and organisational within the NHS are key. By listening to Indigenous colonised peoples, the ex-Empire may find solutions to health inequity. A decolonising feedback loop is required; however, we should take care not to culturally appropriate this valuable reverse innovation. (shrink)

Working in four scholarly teams focused on different global regions—North America, the European Union, the Middle East, and China—the contributors to _Religion, Secularism, and Political Belonging_ examine how new political worlds intersect with locally specific articulations of religion and secularism. The chapters address many topics, including the changing relationship between Islam and politics in Tunisia after the 2010 revolution, the influence of religion on the sharp turn to the political right in Western Europe, understandings of Confucianism as a form of (...) secularism, and the alliance between evangelical Christians and neoliberal business elites in the United States since the 1970s. This volume also provides a methodological template for how humanities scholars around the world can collaboratively engage with sweeping issues of global significance. Contributors. Markus Balkenhol, Elizabeth Bentley, Kambiz GhaneaBassiri, David N. Gibbs, Ori Goldberg, Marcia Klotz, Zeynep Kurtulus Korkman, Leerom Medovoi, Eva Midden, Mohanad Mustafa, Mu-chou Poo, Shaul Setter, John Vignaux Smith, Pooyan Tamimi Arab, Ernst van den Hemel, Albert Welter, Francis Ching-Wah Yip, Raef Zreik. (shrink)

This book presents a timely reconfiguration of the relations between art, philosophy, ethics, and aesthetics. Through connection with a range of contemporary social and philosophical issues and movements, this collection of essays highlights the imperative of sensorial aesthetics. The book focuses on the radical philosophical approach to aesthetics enabled by the works of Jean-François Lyotard and Gilles Deleuze. From these philosophers an older meaning of aesthetic has been recalled. Before it indicated primarily the theory of art and beauty, “aesthetic” referred (...) to the sensibility, the capacity to receive sensations. In summoning this “sensorial” meaning of aesthetics in their respective works, Lyotard, Deleuze, and other recent thinkers turn the philosophical theory of aesthetics away from the dominance of cognitivist and reception theories, and towards a thinking of aesthetics through considerations of the movements of matter, affect, and sensation. (shrink)

Disability is primarily a social phenomenon -- a way of being a minority, a way of facing social oppression, but not a way of being inherently or intrinsically worse off. This is how disability is understood in the Disability Rights and Disability Pride movements; but there is a massive disconnect with the way disability is typically viewed within analytic philosophy. The idea that disability is not inherently bad or sub-optimal is one that many philosophers treat with open skepticism, and sometimes (...) even with scorn. The goal of this book is to articulate and defend a version of the view of disability that is common in the Disability Rights movement. To be physically disabled is not to have a defective body, but simply to have a minority body. (shrink)

Instead of treating art as a unique creation that requires reason and refined taste to appreciate, Elizabeth Grosz argues that art-especially architecture, music, and painting-is born from the disruptive forces of sexual selection. She approaches art as a form of erotic expression connecting sensory richness with primal desire, and in doing so, finds that the meaning of art comes from the intensities and sensations it inspires, not just its intention and aesthetic. By regarding our most cultured human accomplishments as (...) the result of the excessive, nonfunctional forces of sexual attraction and seduction, Grosz encourages us to see art as a kind of bodily enhancement or mode of sensation enabling living bodies to experience and transform the universe. Art can be understood as a way for bodies to augment themselves and their capacity for perception and affection-a way to grow and evolve through sensation. Through this framework, which knits together the theories of Charles Darwin, Henri Bergson, Gilles Deleuze, Félix Guattari, and Jakob von Uexküll, we are able to grasp art's deep animal lineage. Grosz argues that art is not tied to the predictable and known but to new futures not contained in the present. Its animal affiliations ensure that art is intensely political and charged with the creation of new worlds and new forms of living. According to Grosz, art is the way in which life experiments with materiality, or nature, in order to bring about change. (shrink)

A key feature of facial behavior is its dynamic quality. However, most previous research has been limited to the use of static images of prototypical expressive patterns. This article explores the role of facial dynamics in the perception of emotions, reviewing relevant empirical evidence demonstrating that dynamic information improves coherence in the identification of affect (particularly for degraded and subtle stimuli), leads to higher emotion judgments (i.e., intensity and arousal), and helps to differentiate between genuine and fake expressions. The findings (...) underline that using static expressions not only poses problems of ecological validity, but also limits our understanding of what facial activity does. Implications for future research on facial activity, particularly for social neuroscience and affective computing, are discussed. (shrink)

Social constructionism is often considered a form of anti-realism. But in contemporary feminist philosophy, an increasing number of philosophers defend views that are well-described as both realist and social constructionist. In this paper, I use the work of Sally Haslanger as an example of realist social constructionism. I argue: that Haslanger is best interpreted as defending metaphysical realism about social structures; that this type of metaphysical realism about the social world presents challenges to some popular ways of understanding metaphysical realism.

Much of the literature on the relationship between belief and credence has focused on the reduction question: that is, whether either belief or credence reduces to the other. This debate, while important, only scratches the surface of the belief-credence connection. Even on the anti-reductive dualist view, belief and credence could still be very tightly connected. Here, I explore questions about the belief-credence connection that go beyond reduction. This paper is dedicated to what I call the independence question: just how independent (...) are belief and credence? I look at this question from two angles: a descriptive one (as a psychological matter, how much can belief and credence come apart?) and a normative one (for a rational person, how closely connected are belief and credence?) Ultimately, I suggest that the two attitudes are more independent than one might think. (shrink)

Many evidentialists are impermissivists. But there’s no in-principle reason for this. In this paper, I examine and motivate permissivist evidentialism. Not only are permissivism and evidentialism compatible but there are unique benefits that arise for this combination of views. In particular, permissivist evidentialism respects the importance of evidence while capturing its limitations and provides a plausible and attractive explanation of the relationship between the epistemic and non-epistemic. Permissivist evidentialism is thus an attractive option in logical space that hasn’t received enough (...) attention. (shrink)

If the world itself is metaphysically indeterminate in a specified respect, what follows? In this paper, we develop a theory of metaphysical indeterminacy answering this question.

This new and important study of semantic change examines how new meanings arise through language use, especially the various ways in which speakers and writers experiment with uses of words and constructions in the flow of strategic interaction with addressees. In the last few decades there has been growing interest in exploring systemicities in semantic change from a number of perspectives including theories of metaphor, pragmatic inferencing, and grammaticalization. Like earlier studies, these have for the most part been based on (...) data taken out of context. This book is the first detailed examination of semantic change from the perspective of historical pragmatics and discourse analysis. Drawing on extensive corpus data from over a thousand years of English and Japanese textual history, Traugott and Dasher show that most changes in meaning originate in and are motivated by the associative flow of speech and conceptual metonymy. (shrink)

Women as commercial baby factories, nature as an economic resource, life as one big shopping mall: This is what we get when we use the market as a common ...

Carnal Knowledge is an outcome of the renewed energy and interest in moving beyond the discursive construction of reality to understand the relationship between what is conceived of as reality and materiality, described as the "material turn." It draws together established and emerging writers, whose research spans dance, music, film, fashion, design, photography, literature, painting and stereo-immersive VR, to demonstrate how art allows us to map the complex relations between nature and culture, between the body, language and knowledge. These writings (...) are unique in the field because they represent the authors' commitment to a new materialism through the creative arts. The questions they address include: Does the material turn in the creative arts take a different turn from continental epistemology, philosophy and the humanities? How does the agency of matter, the material nature of artistic practice and the notion of "truth to materials" affect what we understand as the "new materialism?" In engaging with these questions the book offers perspectives on the emergence of this exciting fresh field of new materialism. (shrink)

In this project I am concerned with the extent to which conceptual engineering happens in domains outside of philosophy, and if so, what that might look like. Specifically, I’ll argue that...

Feminist epistemology has often been understood as the study of feminine "ways of knowing." But feminist epistemology is better understood as the branch of naturalized, social epistemology that studies the various influences of norms and conceptions of gender and gendered interests and experiences on the production of knowledge. This understanding avoids dubious claims about feminine cognitive differences and enables feminist research in various disciplines to pose deep internal critiques of mainstream research.

In a recent paper, Barry Loewer attempts to defend Humeanism about laws of nature from a charge that Humean laws are not adequately explanatory. Central to his defense is a distinction between metaphysical and scientific explanations: even if Humeans cannot offer further metaphysical explanations of particular features of their “mosaic,” that does not preclude them from offering scientific explanations of these features. According to Marc Lange, however, Loewer’s distinction is of no avail. Defending a transitivity principle linking scientific explanantia to (...) their metaphysical grounds, Lange argues that a charge of explanatory inadequacy resurfaces once this intuitive principle is in place. This paper surveys, on behalf of the Humean, three strategies for responding to Lange’s criticism. The ready availability of these strategies suggests that Lange’s argument may not bolster anti-Humean convictions, since the argument rests on premises that those not antecedently sharing these convictions may well reject. The three strategies also correspond to three interesting ways of thinking about relations of grounding linking Humean laws and their instances, all of which are consistent with theses of Humean supervenience, and some of which have been heretofore overlooked. (shrink)

I offer an account of what trust is, and of what epistemic self-trust consists in. I identify five distinct arguments extracted from Chapter 2 of Zagzebski's Epistemic Authority for the rationality and epistemic legitimacy of epistemic self-trust. I take issue with the general account of human rational self-regulation on which one of her arguments rests. Zagzebski maintains that this consists in restoring harmony in the psyche by eliminating conflict and so ending. I argue that epistemic rationality is distinct from psychic (...) mechanisms aimed at eliminating dissonance, and these two sometimes pull in opposed directions. (shrink)

An exploration of the meaning and role of the concepts of empathy and sympathy in Herder’s thought, showing that the two concepts permeate his entire philosophy.

Credences are similar to levels of confidence, represented as a value on the [0,1] interval. This chapter sheds light on questions about credence, including its relationship to full belief, with an eye toward the empirical relevance of credence. First, I’ll provide a brief epistemological history of credence and lay out some of the main theories of the nature of credence. Then, I’ll provide an overview of the main views on how credences relate to full beliefs. Finally, I’ll turn to the (...) empirical, and suggest some ways that cognitive science does and could answer questions about credence, such as what credences one has, how credences relate to beliefs, and the extent to which we can control our credences. (shrink)

There is no prepared script for social and cultural life. People work it out as they go along. Creativity and Cultural Improvisation casts fresh, anthropological eyes on the cultural sites of creativity that form part of our social matrix. The book explores the ways creative agency is attributed in the graphic and performing arts and in intellectual property law. It shows how the sources of creativity are embedded in social, political and religious institutions, examines the relation between creativity and the (...) perception and passage of time, and reviews the creativity and improvisational quality of anthropological scholarship itself. Individual essays examine how the concept of creativity has changed in the history of modern social theory, and question its applicability as a term of cross-cultural analysis. The contributors highlight the collaborative and political dimensions of creativity and thus challenge the idea that creativity arises only from individual talent and expression. (shrink)

I present an explanatory argument for the reasons-first view: It is superior to knowledge-first views in particular in that it can both explain the specific epistemic role of perception and account for the shape and extent of epistemic justification.

The third part, Cognition, concerns abstract questions about knowledge and truth as well as more concrete questions about the usefulness and tractability of various graphic representations of information. The book would be of special interest to Research Institutes in Computer Science, Researchers in Philosophical Logic, Deontic Logic, Applied Logic, Artificial Intelligence, and Cognitive Science.